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巴西的胃癌治疗:巴西胃癌协会的一项多中心研究。

Gastric cancer treatment in Brazil: a multicenter study of the Brazilian Gastric Cancer Association.

作者信息

Ramos Marcus Fernando Kodama Pertille, Pereira Marina Alessandra, Ribeiro Thiago Francischetto, Braghiroli Neto Oddone, Coimbra Felipe José Fernandez, Rodrigues Marco Antônio Gonçalves, Sabino Flavio Duarte, Ribeiro Junior Ulysses, Cuenca Ronaldo Mafia, Victer Felipe Carvalho, Tomasich Flávio Daniel Saavedra, Ishak Geraldo, Kalil Antonio Nocchi, Ferraz Álvaro Antônio Bandeira, Moreira Luis Fernando, Quireze Junior Claudemiro, Andreollo Nelson Adami, Castro Osvaldo Antônio Prado, Pinheiro Fernando Antônio Siqueira, Weston Antônio Carlos

机构信息

- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Instituto do Câncer - São Paulo - SP - Brasil.

- Hospital Aristides Maltez, Liga Bahiana Contra o Câncer, Cirurgia - Salvador - BA - Brasil.

出版信息

Rev Col Bras Cir. 2025 May 12;52:e20253815. doi: 10.1590/0100-6991e-20253815_en. eCollection 2025.

Abstract

INTRODUCTION

Gastric cancer (GC) has distinct characteristics and management according to the region of the world, and the objective of our study was to evaluate how it is being managed in Brazil.

METHODS

This is a multicenter study that involved 18 oncology referral centers. Data were collected using the REDCap platform and compiled at the end of one year.

RESULTS

All Brazilian regions were represented, and 635 patients were included. Most patients were from the Southeast (40.6%) and Northeast (29.6%) regions. The mean age was 62 years, with a predominance of males. Most patients (84.6%) had good performance status, with an ECOG score of 1-2. Less than 10% of patients were covered by medical insurance. A quarter of the patients underwent diagnostic laparoscopy, but endoscopic ultrasound and PET scans were rarely performed. The cT3 category was the most common (40.6%), lymph node involvement was described in 48.9%, and distant metastases, in 14.4% of the staging exams. The final cTNM staging was III (29.4%), II (26%), I (24.2%) and IV (20.5%). Most patients underwent surgery with curative intent (74.4%) and open access (82.8%). Preoperative chemotherapy was performed in 37.2% of cases, and the most common surgical procedures were subtotal gastrectomy (45.3%) and total gastrectomy (33.1%).

CONCLUSION

The present study allowed us to evaluate the current panorama of surgical treatment of Gastric Cancer, representing all regions of Brazil. Stage III, distal, and diffuse tumors continue to be prevalent in Brazil, and there has been relevant use of diagnostic laparoscopy, preoperative chemotherapy, and minimally invasive surgery.

摘要

引言

胃癌(GC)在世界不同地区具有不同的特征和治疗方式,我们研究的目的是评估巴西对其的治疗情况。

方法

这是一项多中心研究,涉及18个肿瘤转诊中心。数据通过REDCap平台收集,并在一年结束时进行汇总。

结果

涵盖了巴西所有地区,共纳入635例患者。大多数患者来自东南部(40.6%)和东北部(29.6%)地区。平均年龄为62岁,男性占主导。大多数患者(84.6%)身体状况良好,东部肿瘤协作组(ECOG)评分为1 - 2分。不到10%的患者有医疗保险覆盖。四分之一的患者接受了诊断性腹腔镜检查,但内镜超声和PET扫描很少进行。cT3类别最为常见(40.6%),48.9%的分期检查显示有淋巴结受累,14.4%有远处转移。最终的cTNM分期为III期(29.4%)、II期(26%)、I期(24.2%)和IV期(20.5%)。大多数患者接受了根治性手术(74.4%),且采用开放手术入路(82.8%)。37.2%的病例进行了术前化疗,最常见的手术方式是胃次全切除术(45.3%)和全胃切除术(33.1%)。

结论

本研究使我们能够评估巴西胃癌手术治疗的现状,涵盖了巴西所有地区。III期、远端和弥漫性肿瘤在巴西仍然很普遍,并且诊断性腹腔镜检查、术前化疗和微创手术得到了广泛应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36e0/12037263/a53fa1a9124b/rcbc-52-e20253815-g001.jpg

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